State report faults Monroe Community Hospital director Todd Spring

His contact with residents restricted; county response due Thursday

Apr. 24, 2013

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The administration of Monroe Community Hospital did not protect the well-being of its residents as it should have, the state Department of Health concluded after an inspection of the county-owned nursing home in March.

The report, obtained Wednesday by the Democrat and Chronicle, does not name any individuals, but the executive director is Todd C. Spring.

During its inspection, the state placed the facility under “immediate jeopardy,” the most severe designation. It means the problems found either have caused or could cause serious harm or death if left uncorrected.

The investigation also noted MCH failed to report the abuse as required under law. Nor did it recognize the abuse or take steps to protect residents from being harmed.

Based on record reviews and staff interviews, the state determined “the facility was not administered in a manner that enabled it to use its resources effectively and efficiently to attain or maintain the highest practicable physical, mental and psychosocial well-being of each resident.”

As part of its plan to have the immediate jeopardy label lifted, the facility agreed March 28 that Spring would have no contact with residents unless other staff members were present. The administrator also was not allowed to discuss the incident with staffers. Those restrictions would remain in effect until the state accepts MCH’s final plan to correct all problems.

Wednesday afternoon, county communications director Justin Feasel said Spring still was the executive director of the 566-bed facility, which provides long-term care to people of all ages with complex and chronic conditions.

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Feasel said the county would comment Thursday, after it files a required response with the state.

Spring was hired in January 2000 as deputy director of MCH and was appointed director in September 2003, according to Feasel. Spring’s salary is $139,798.

The Department of Health was conducting its annual inspection of MCH last month when the survey team was told of the incident involving Spring and the resident.

The allegations were first made public by Karen Fabi, the former safety and security director for MCH, and reported last week by the Democrat and Chronicle after they were confirmed by others familiar with the situation.

According to the report Fabi filed with human resources at MCH, the resident was Samuel Condello, 77, who died in January.

While the inspection found lapses in care of other residents by different levels of nursing staff, the bulk of the report centered on the actions of Spring toward Condello because of his smoking.

According to the report, Condello had signed a contract in April 2011, in which he agreed to smoke in designated areas during specific times and acknowledged that violations may result in loss of smoking privileges. The contract did not include loss of mobility as a punishment.

In the report, Spring stated that Condello was a safe smoker but not in the right areas. There were no documented incident reports or security reports related to smoking infractions from Oct. 1 to Dec. 6, 2012.

On Dec. 6, staff members took away Condello’s power wheelchair and gave him a manual one that included an alarm to monitor his movements. His smoking privileges also were revoked. At 10 p.m., it was noted the manual wheelchair had been taken by “the Administrator” because the resident had left the unit to smoke. The report said there were no medical orders or changes to the care plan to show that he could not have a manual chair or leave the unit after 3 p.m.

The manual chair was returned Dec. 10, the report showed. In the intervening time, there were notes that Condello spent the time in bed.

There were several pages detailing interviews with employees about the incident, Condello’s reaction and their own fear of retribution if they reported the incident.

The state lifted the immediate jeopardy designation March 29, one day after MCH agreed to several corrective actions, including the restrictions on Spring. Among them:

• A resident’s freedom of movement would be restricted only if the individual is an imminent risk to self or others, and only after all less restrictive measures have been tried.

• Direct care staff will have training on the legal requirement of reporting abuse.

• Staff is expected to speak up without fear of retribution to protect residents’ rights.